Commissioning Update Young People Substance Misuse (YPSM) service

IOW Joint Commissioning Group (JCG)
March 2010
General: 

This quarter we have experienced considerable increase with the reported use of Mephedrone (also known as MCat; Meph; Bubble et al) with young people. Of the 84 active clients engaged with Get Sorted 60% of young people report having used or are using this ‘Legal High’ regularly. Increase in telephone calls from concerned parents and professionals are very noticeable with requests for more information being distributed. 

Get Sorted hosted a “Legal High” training day on 16th March 2010 presented by Liam Watson of Drugs Education Training; offering harm reduction advice and more in depth information than has been available. The range of professionals in additional to the Get Sorted Team attended included those working with young people from three young people’s housing providers; NHS Midwife and Children’s Ward Staff Nurse; three professionals from Portsmouth & Southampton Young People’s Services; Children’s Services; 16+ Team; Youth Offending Team (YOT); Specialist Child and Adolescent Health Services (SpCAMHS); Early Interventions; Connexions; AESOP (Early Interventions Services of Psychosis); Challenge & Adventure; plus adult service providers; Cranstoun; IDAS; Result User Group; Police Intelligence; PCSO; DAAT/BBV and the DAAT Commissioner. The feedback from the day was excellent with over 40 attendees.

With the young people’s budget cut and the loss of one practitioner (as well as the transition post previously funded by Cranstoun not being replaced since July 2009 making a total of two posts) this has put a strain on the Service and indicates a gap developing in service provision. Ongoing communication with young people’s housing providers and the Isle of Wight College professionals have shared concerns that while there has been additional support from Cranstoun which has been helpful that they are experiencing young adults up to the age of 24 who are declining to engage; the professionals attribute this partly to the lack of emotionally maturity alongside other contributing factors. A proposal has been developed with the Commissioner to support a transitional role with a clear exit strategy.

The YPSM overall performance continues to be good and a marked improvement for the first quarter with 100% was achieved for the completion of Treatment Outcome Profiles (TOP) at modality start and 100% at discharge; with the percentage of people with a planned discharge continually improving and climbing to 80%.  The YPSM team continues to perform high with reporting accuracy across the board.

YPSM continues to support Gatekeeping and CAF meetings consistently to support a multi-agency panel approach to identifying young people at risk with substance misuse issues. This has given us the opportunity for professional relationships to improve with SpCAMHS as well as Universal services and Lead Professionals to share practise and offer support to the three localities across the island.

The project to develop the electronic data and case file management system has temporarily come to a standstill due to the Council’s implementation of the new SAP system and technical difficulties needing to be ironed out. Historic data continues to be entered into the system by the administrative support – this role has been extended until of August 2010.  

We continue to address the challenge of the lack of accessibility for young people to our service due to the physical location of the office; we are in communications with Universal services around sharing premises and will continue to update as this progresses. The aim is to be linked with an open access service.

Top priorities for 2010 update:

YPSM Treatment Plan:

1.	Proposal for transition post with funds from underspend from adult treatment plan

2.	Hidden Harm - project for young carers’ agreed around positive activities and building upon self esteem and reducing the risk of harm. The target group has been identified as a group of young people presenting with risks around alcohol and substance misuse; supporting people to participate in a group project called Challenge and Adventure. A professionals meeting is due to take place this month to establish a framework, targets and outcomes.

3.	The pilot for the Arrest and Referral scheme for young people via the YOT post is currently in place and aims to continue the project based upon funding for the post. Additionally implementation and completion of the YRO training and development to deliver drug testing to young people is in the final stages. Training is in collaboration with Wessex Youth Offending Teams and Young People’s Substance Misuse services across the Isle of Wight and the Hampshire areas with joint agreements for policies and procedures being finalized.

4.	Service user involvement – continue to explore ways of engaging difficult to engage young with and in preparation of robust involvement for the future needs assessment.

5.	Meet NTA targets

o	Percentage of referrals from children and families to increase – this is currently a challenge as the Lead Professionals from the CAF’s are generally being identified from universal services; this does not necessarily identify that the young person is involved with children and families. This was presented to the NTA at a recent YP meeting to request that reporting be investigated to identify young people involved with multiple agencies and therefore supporting that we are meeting this need. 
o	Planned discharges improved and target to be met 
o	Completion of review TOP forms improving with statistics to support this
o	Training for new data set

6.	Links with Child and Adolescent Mental Health Services continue to improve with joint assessments being offered to some complex young people and stronger links with a variety of agencies.

7.	Improved links with different teams of Children’s Services and Adult Services for referral pathway continues with requests for attendance at team meetings across services.

8.	CAF – implementation and ensuring appropriate information sharing training has been completed and is reviewed in team meetings.

9.	Develop and update clinical governance.

10.	Participate in the development and implementation of the Alcohol Strategy for Young People with Commissioners and Children’s Trust.